JAAOS - 2026-08-11 - Journal Article
Evaluating the Accessibility of Online Resources Regarding Biceps Tenodesis.
Allen M, Beluzo B, Sethi S, Christiansen MJ, Mulcahey MK
Topics
Key Takeaway
79.3% of online biceps tenodesis resources exceed recommended 6th-8th grade reading levels, with a mean Flesch-Kincaid Grade Level of 9.8 and Gunning Fog Index of 13.7.
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Summary
This study evaluated the readability and credibility of online patient-facing resources for biceps tenodesis using SEO Minion to extract 400 'People Also Ask' results across four search terms. Readability was assessed via FKGL, Gunning Fog Index, and Flesch-Kincaid Reading Ease; credibility via JAMA benchmark criteria. Journal sources were most common (28.8%) and most credible (JAMA score 3.2) but least readable (FKGL 11.5), while government sites were most readable (FKGL 4.1) but represented only 3.3% of results.
Key Limitation
The JAMA benchmark credibility tool assigns scores based on authorship, attribution, disclosure, and currency—not clinical accuracy—so a highly readable, credible-scoring source may still contain factually incorrect surgical information.
Original Abstract
INTRODUCTION
Pathology of the long head of the biceps tendon is a frequent source of shoulder pain. Biceps tenodesis is a common surgical intervention, and many patients seek information online. The readability and quality of online resources regarding biceps tenodesis remain unexamined. The purpose of this study was to evaluate the source type, readability, and quality of online patient-facing resources regarding biceps tenodesis.
METHODS
Search Engine Optimization Minion extracted "People Also Ask" (PAA) questions from four terms: "biceps tenodesis," "biceps tenodesis indications," "biceps tenodesis complications," and "biceps tenodesis recovery." Searches were done in an incognito browser with data cleared. Three reviewers categorized sources and assessed credibility using the Journal of the American Medical Association (JAMA) benchmark criteria and readability using the Flesch-Kincaid Grade Level (FKGL), Flesch-Kincaid Reading Ease, and Gunning Fog Index against national patient-education standards.
RESULTS
Four hundred queries and associated sources were analyzed. Journals were the most common (115, 28.8%), followed by academic sources (107, 26.8%) and medical practice websites (73, 18.3%). Most sources (317, 79.3%) exceeded recommended sixth-grade to eighth-grade levels: mean FKGL 9.8 (SD = 2.5), GFI 13.7 (SD = 2.7), and FKRE corresponding to grade level 12.5 (SD = 2.9). The mean JAMA score was 2.2 (SD = 0.9). Government websites were the easiest to read, FKGL M = 4.1 (SD = 0.0); GFI M = 7.8 (SD = 0.0), and moderately credible, JAMA M = 2.0 (SD = 0.0), but represented only 13 (3.3%). Journal sources had the highest credibility, JAMA M = 3.2 (SD = 0.5), yet the lowest readability, FKGL M = 11.5 (SD = 2.1); GFI M = 15.3 (SD = 2.0).
CONCLUSION
The prevalence of difficult-to-read and low-quality information on biceps tenodesis highlights a gap between patient interest and the quality of accessible resources. Future efforts should explore simplifying medical content and improving the readability of online materials related to biceps tenodesis.